NPI | 1750740957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 7229) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7229) |
103TP2701X Psychologist, Group Psychotherapy (Licence: OH 7229) | |
Enumeration Date | 2016-02-16 |
Last Update Date | 2021-03-30 |